Bertin Nicole, Favretto Serena, Pelizzo Francesco, Mos Lucio, Pertoldi Franco, Vriz Olga
University of Udine, Udine, Italy.
University of Eastern Piedmont, Novara, Italy.
J Investig Med High Impact Case Rep. 2017 Jun 8;5(2):2324709617713511. doi: 10.1177/2324709617713511. eCollection 2017 Apr-Jun.
Carcinoid syndrome is the constellation of symptoms mediated by humoral factors produced by some carcinoid tumors. It consists primarily of vasomotor symptoms, gastrointestinal hypermotility, hypotension, and bronchospasm, due to the production and release of vasoactive substances. Carcinoid heart disease occurs in more than 50% of patients with carcinoid syndrome; in some cases, it represents the initial manifestation of the disease. We report the case of a 75-year-old woman with a metastatic neuroendocrine tumor admitted to the emergency room for fatigue and heart failure. Transthoracic echocardiography showed severe tricuspid and pulmonic regurgitation suggesting carcinoid heart disease. A hypervascular retroperitoneal mass was found on abdominal computed tomography, which seemed to arise from the mesenteric artery, anteriorly to the abdominal aorta. Unfortunately, our patient was neither a candidate for mass resection nor for cardiac surgery due to advanced metastatic disease and poor clinical condition. Additionally, we performed a systematic literature review of carcinoid heart disease focusing on typical echocardiographic findings.
类癌综合征是由某些类癌肿瘤产生的体液因子介导的一系列症状。它主要由血管舒缩症状、胃肠运动亢进、低血压和支气管痉挛组成，这是由于血管活性物质的产生和释放所致。类癌性心脏病发生在超过50%的类癌综合征患者中；在某些情况下，它是该疾病的初始表现。我们报告了一例75岁女性转移性神经内分泌肿瘤患者，因疲劳和心力衰竭入住急诊室。经胸超声心动图显示严重的三尖瓣和肺动脉反流，提示类癌性心脏病。腹部计算机断层扫描发现一个高血管性腹膜后肿块，似乎起源于肠系膜动脉，位于腹主动脉前方。不幸的是，由于晚期转移性疾病和较差的临床状况，我们的患者既不适合进行肿块切除，也不适合进行心脏手术。此外，我们对类癌性心脏病进行了系统的文献综述，重点关注典型的超声心动图表现。
